CMS releases FY 2014 IRF, SNF final rules   07/31/2013
The Centers for Medicare & Medicaid Services today released final rules for fiscal year 2014 for the inpatient rehabilitation and skilled nursing facility prospective payment systems. IRFs will receive an estimated 2.3% increase ($170 million) in Medicare payments from FY 2013 under the final rule, according to CMS. This reflects a 1.8% payment update, which includes a 2.6% estimated market basket update, minus a 0.5 percentage point productivity adjustment and an additional 0.3 percentage point reduction, as required by law. In an improvement over the proposed rule, it appears CMS will remove fewer codes than originally proposed from those that may count toward an IRF’s 60% Rule compliance assessment using the presumptive test; the shortened list of eligible codes will not take effect for one year. SNFs will receive an estimated 1.3% increase ($470 million) relative to FY 2013 under the other final rule issued today. The increase reflects a 2.3% market basket update minus a 0.5 percentage point productivity adjustment, as well as a 0.5 percentage point forecast error correction. AHA staff are analyzing the rules and members will receive further details.
House committee approves physician payment reform bill   07/31/2013
The House Energy and Commerce Committee today unanimously approved bipartisan legislation (H.R. 2810) that would reform Medicare payment for physician services. The legislation, which does not specify a funding source, would replace the sustainable growth rate with an annual update of 0.5%. Beginning in 2019, physicians practicing in fee for service also would receive a 1% bonus or payment reduction based on performance on quality measures and clinical practice improvement. Those who fail to report quality information would continue to receive a payment reduction under the Physician Quality Reporting Program. The legislation also directs Medicare to identify improperly valued services under the physician fee schedule, which would result in a net reduction of 1% of the projected amount of expenditures during 2016 through 2018. Among other changes, the legislation would pay for care coordination services by certain qualified physicians and create a new avenue for developing and testing alternative payment models.
IOM issues toolkit for crisis care planning   07/31/2013
The Institute of Medicine today issued a toolkit to help emergency response planners, including hospitals, develop indicators and triggers for activating crisis standards of care when insufficient resources are available to provide the normal level of care to all patients in a disaster or public health emergency. The report builds on two previous IOM reports on crisis standards of care, which emphasized the importance of developing indicators and triggers in CSC plans. “Specifically, the toolkit focuses on indicators and triggers that guide transitions along the continuum of care, from conventional standards of care to contingency surge response and standards of care to crisis surge response and standards of care, and back to conventional standards of care,” the authors note. The report contains chapters specific to emergency management, public health, behavioral health, emergency medical services, hospital and acute care, and out-of-hospital care, as well as common elements designed to facilitate integrated planning.
Senate approves NLRB nominees   07/31/2013
The U.S. Senate yesterday confirmed five presidential nominations to the National Labor Relations Board. They are Mark Gaston Pearce, whose current term as board chair expires in August; Kent Hirozawa, currently chief counsel to the NLRB chairman; Nancy Schiffer, former associate general counsel to the AFL-CIO; Philip Miscimarra, a partner in the Labor and Employment Group of Morgan Lewis & Bockius LLP; and Harry Johnson, a partner with Arent Fox LLP who specializes in labor and employment law.